Systematic review of medicinal leech therapy in urology

Abstract Background Medicinal leech therapy, otherwise known as hirudotherapy or leeching, has been utilized for numerous pathologies over centuries. The technique resurfaced in modern medicine for its beneficial effects in microsurgical complications, particularly venous congestion. Recently, sever...

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Main Authors: Alexander O. Battin, Natalie Hobeika, Matthew J. Zdilla
Format: Article
Language:English
Published: SpringerOpen 2023-04-01
Series:African Journal of Urology
Subjects:
Online Access:https://doi.org/10.1186/s12301-023-00351-9
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author Alexander O. Battin
Natalie Hobeika
Matthew J. Zdilla
author_facet Alexander O. Battin
Natalie Hobeika
Matthew J. Zdilla
author_sort Alexander O. Battin
collection DOAJ
description Abstract Background Medicinal leech therapy, otherwise known as hirudotherapy or leeching, has been utilized for numerous pathologies over centuries. The technique resurfaced in modern medicine for its beneficial effects in microsurgical complications, particularly venous congestion. Recently, several cases have documented the utilization of medicinal leech therapy for the management of urologic disease states and surgical complications. It is important to understand the past, present, and future possibilities for hirudotherapy in urology. However, a systematic review of medical leech therapy in this context has yet to be conducted. Accordingly, and with an emphasis on salient clinical details, this study aims to systematically review the cases of hirudotherapy applied to urological conditions. Main body of the abstract A systematic review of cases in MEDLINE/PubMed was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 49 search results, 11 articles detailing 13 unique cases of medicinal leech therapy used in the urological context were included. Hirudotherapy was conducted in 10 of 13 cases (76.9%) for the management of congested blood occurring in five cases post-penile replantation, two cases of postoperative scrotal hematoma, two cases of venous congestion of the glans post-neonatal bladder exstrophy repair, and one case of refractory priapism. Leeching in the remaining three cases was for the management of penoscrotal edema in patients with hormone refractory prostate carcinoma treated with radical radiation therapy. All 13 cases (100%) reported clinical improvement from hirudotherapy. Venous congestion/hematoma cases noted decreased displaced blood volume. The patient experiencing priapism reported decreased pain despite the persistence of cavernosal swelling. The three cases of penoscrotal edema reported significant decreases in swelling due to serous fluid drainage from leech puncture sites. No complications or side effects were reported in the nine adult patients. The four postoperative neonatal patients all required blood product throughout treatment. Short conclusion The systematic review of the cases demonstrates that medicinal leech therapy is a favorable treatment option for individuals with varied urological pathologies and that hirudotherapy may improve post-surgical outcomes in the urological setting. Hirudotherapy should be considered as a viable treatment modality in specific venostatic urological conditions.
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spelling doaj.art-54735f25d3df4fcaa1607f36d33cc1582023-04-23T11:21:21ZengSpringerOpenAfrican Journal of Urology1961-99872023-04-0129111310.1186/s12301-023-00351-9Systematic review of medicinal leech therapy in urologyAlexander O. Battin0Natalie Hobeika1Matthew J. Zdilla2Department of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Robert C. Byrd Health Sciences CenterDepartment of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Robert C. Byrd Health Sciences CenterDepartment of Pathology, Anatomy, and Laboratory Medicine (PALM), West Virginia University School of Medicine, Robert C. Byrd Health Sciences CenterAbstract Background Medicinal leech therapy, otherwise known as hirudotherapy or leeching, has been utilized for numerous pathologies over centuries. The technique resurfaced in modern medicine for its beneficial effects in microsurgical complications, particularly venous congestion. Recently, several cases have documented the utilization of medicinal leech therapy for the management of urologic disease states and surgical complications. It is important to understand the past, present, and future possibilities for hirudotherapy in urology. However, a systematic review of medical leech therapy in this context has yet to be conducted. Accordingly, and with an emphasis on salient clinical details, this study aims to systematically review the cases of hirudotherapy applied to urological conditions. Main body of the abstract A systematic review of cases in MEDLINE/PubMed was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 49 search results, 11 articles detailing 13 unique cases of medicinal leech therapy used in the urological context were included. Hirudotherapy was conducted in 10 of 13 cases (76.9%) for the management of congested blood occurring in five cases post-penile replantation, two cases of postoperative scrotal hematoma, two cases of venous congestion of the glans post-neonatal bladder exstrophy repair, and one case of refractory priapism. Leeching in the remaining three cases was for the management of penoscrotal edema in patients with hormone refractory prostate carcinoma treated with radical radiation therapy. All 13 cases (100%) reported clinical improvement from hirudotherapy. Venous congestion/hematoma cases noted decreased displaced blood volume. The patient experiencing priapism reported decreased pain despite the persistence of cavernosal swelling. The three cases of penoscrotal edema reported significant decreases in swelling due to serous fluid drainage from leech puncture sites. No complications or side effects were reported in the nine adult patients. The four postoperative neonatal patients all required blood product throughout treatment. Short conclusion The systematic review of the cases demonstrates that medicinal leech therapy is a favorable treatment option for individuals with varied urological pathologies and that hirudotherapy may improve post-surgical outcomes in the urological setting. Hirudotherapy should be considered as a viable treatment modality in specific venostatic urological conditions.https://doi.org/10.1186/s12301-023-00351-9Hirudo medicinalisHirudotherapyLeechingSystematic reviewUrology
spellingShingle Alexander O. Battin
Natalie Hobeika
Matthew J. Zdilla
Systematic review of medicinal leech therapy in urology
African Journal of Urology
Hirudo medicinalis
Hirudotherapy
Leeching
Systematic review
Urology
title Systematic review of medicinal leech therapy in urology
title_full Systematic review of medicinal leech therapy in urology
title_fullStr Systematic review of medicinal leech therapy in urology
title_full_unstemmed Systematic review of medicinal leech therapy in urology
title_short Systematic review of medicinal leech therapy in urology
title_sort systematic review of medicinal leech therapy in urology
topic Hirudo medicinalis
Hirudotherapy
Leeching
Systematic review
Urology
url https://doi.org/10.1186/s12301-023-00351-9
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